| NPI | 1467848416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL W DURBIN Owner 270-443-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |